My Visit to the Emergency Room at Mercy Hospital in Iowa City

Each Person is Important

When I was a teenager, I worked at McDonalds. I took the job to earn a little extra money, but over the years I’ve realized that I got much more out of that job than some extra spending money. At least in my case, I really learned, internalize, and honed a valuable work ethic. I was at an age where I was receptive, so it wasn’t a chore I resisted. I also learned that something as simple as a small bag of French Fries is important. Each customer — each person — is important.

We’d use stopwatches to time how long it took for a customer to wait in line, have their order taken, and get their food. My manager told me it was critical to provide prompt attentive service. I was told my work was important. We’d all compete with each other to see how quickly we could provide exceptional service. There was a comprehensive video training program, and we’d get credit for continuing education.

As I continued in life, I held on to the idea that even a simple task such as providing someone with an order of fries was very important and should be done thoughtfully. When I began my career as a computer support specialist, I felt my work was even more important than giving a person french fries. So, I determined that computer work deserved an equal or greater level of attention, responsiveness, and care.

Mysterious Abdominal Pain

Last week I had a sharp pain in my abdomen. It persisted over a few days, so I went to one of the exceptional satellite care centers we have in our area. These are the offices you go to as a first point of contact. They are limited in what they can provide, but they are convenient, fast, and a good way to see a doctor quickly for an assessment of what to do next.

The doctor I saw told me to go to the emergency room immediately. The concern with abdominal pain is that it could be just about anything from intestinal gas to a life-threatening appendicitis or other serious condition.

The ‘Other’ Hospital

I went to the emergency room of a local hospital.* Upon arriving and beginning the check-in process, my first question, was how long it might be — considering the pain I was in. My wife asked and got the response, “I don’t know,” from the person at the check-in window. My wife persisted, “Will it be an hour? Two hours? Four hours?” The answer came back again, this time a little more rudely, “I really don’t know.”

I looked around the waiting room, and seeing that almost all the seats were empty, and only a few people were there comfortably reading magazines, I couldn’t imagine why we wouldn’t be seen right away, and couldn’t understand why we wouldn’t be given at least a general estimate of when we might be seen. From the person’s expression at the check-in window, it was clear our presence there was an unwanted inconvenience. While DMV offices are known for a long wait and sometimes poor service, at least you get to take a number and know where you are in the queue.

Just getting to that ER was challenging. The narrow winding road with multiple unexpected sharp turns, and painful potholes, arrives at a confined dead-end entrance area where you’d imagine a loading dock to be. The few parking spots close to the door were already taken. Then there was the entrance. Sliding doors. Enter the first set of doors on the right. Then the next door requires you enter on the left. Trying to move in a serpentine motion isn’t so easy when you’re not feeling well. Then there were obstructions to reaching the check-in window. It was like an obstacle course. They certainly weren’t making it easy or convenient for people.

After some time went by, with nobody in the waiting room getting called, it was clear that things weren’t just moving slowly. They weren’t moving at all. We decided to cancel the check-in, but by then there was nobody at the check-in window and no hospital employees in sight. Hmmm… “How do we even get out of this?” I didn’t want to get an emergency room visit fee. Finally the grumpy person returned, and we told them we’d be going to a different hospital. They gave no response. Just a smirk.

Emergency Room Experience at Mercy Hospital

We went as fast as we could to Mercy Hospital in Iowa City. The hospital was easy to find. The emergency room entrance was easy to get to. There was abundant parking close by.

We entered and were immediately attended to by a cheerful person at one of the many check-in windows.

After my previous experience, I thought I should ask how long it might be before I could see a doctor.

“It’s an emergency room, so right away,” she responded smiling, but also looking a little perplexed.

I explained, “It’s just that the last emergency room we visited was very unfriendly and they wouldn’t tell us when I’d be seen by a doctor. They said it might be four hours.”

She smiled and said at Mercy they try to have people with a doctor in triage within 5 minutes of their arrival. “Would you like a warm blanket?” she asked. “Not right now, thanks,” I replied.

I felt like I was flying first class or checking in at some kind of fancy resort.

I asked where the restroom was.

She responded, “It’s right over there. Here, take this,” and handed me a urine sample cup. In most doctor’s offices you sit in the waiting room, and then after a while see a nurse who gives you the sample cup, but only if its deemed necessary, and usually after you’ve already gone to the bathroom.

The moment I stepped out of the restroom the doctor was ready to see me.

So, I was being seen and cared for in minutes after my arrival.

A few more minutes later, there was a team of nurses and doctors surrounding me working on diagnosing what might be causing my abdominal pain — asking me various questions to rule out bladder infection, pancreatitis, bowl obstruction, appendicitis, hernia, and various other possible causes. “You may need to go into surgery,” one of them told me.

Comprehensive lab work was done with blood and urine samples. A full CT scan was performed by two technicians.

In all, I think there were about 12 medical professionals attending to me, including the doctors, nurses, CT technicians, lab technicians, and other staff.

It was the kind of care you’d imagine a dignitary or celebrity getting — but that’s just apparently how they treat everyone.

Well, the good news is that the sharp pain was apparently caused by a pulled abdominal muscle. I just needed to rest up and get better. After knowing it wasn’t something more serious, my worries subsided and the pain subsided (with the help of the pain medication they gave me in my IV line).

I was home in time for lunch — rather than still writhing in pain at the other hospital.

The prompt and caring service at Mercy reminded me of when I was younger, working at McDonalds, learning that if bag of fries is important, then certainly something like caring for a person’s medical needs should be more important and deserving of fast, professional, compassionate care. It helped me to set a standard of excellence in the most menial of tasks, so I’d always excel beyond that in other areas.

Painful experiences are always difficult, but I can say I’m glad I had the opportunity to visit Mercy Hospital that day.

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P.S. Thanks! To those who’ve asked… Yes, I’m feeling much better now. Thanks! 🙂

P.P.S. Comparison Data. I didn’t discover it until later, but ProPublica has an online ER wait time comparison guide based on data collected between April 2013 and March 2014. I’m not sure how representative that data is a year later, and don’t know how accurate the data collection was. It would be nice to have a national map showing real-time data collected live from hospitals across the country.

P.P.P.S. Praise & Criticism. It’s always a good idea to offer praise publicly, and criticism privately. So, I didn’t mention the name of the ‘other’ hospital in my writing. Additionally, while personal experiences are helpful to encourage and coach teams, overall assessments of an institution should be made with longitudinal data from the experiences of many people over time.

P.P.P.P.S Comments. Okay, so it’s been about a week since I shared my story online, and I didn’t realize that people had been posting comments below awaiting approval. Sorry about that! I’ve approved them all, and replied to each one. To those of you who felt I was too harsh on the ‘other’ hospital. I have another story to share from this week about a very positive experience with the other hospital. No, I don’t plan to start a weekly journal about hospital visits. 😉


Impact: The Rest of the Story

When we make an extra effort to go above and beyond in our workplace, or perhaps maybe outside of work we do something nice through a special act of kindness, one often wonders what the impact is. Today, with social media, we can actually see the impact visually. The maps below show people who have read this story, and then were moved to share it with others, who shared it with others, and so on. Exceptional acts of excellence and kindness are inspiring. They encourage others to raise the bar, to do more, to do better, to be better.

For the nurse who is tired after many long shifts, who has had a difficult week, but chooses to set those things aside and give one more smile while focusing on someone in need or in pain… That nurse wonders what impact their kindness has in the world. Here’s the impact.

In the few hours after posting this story, 230 people had shared it, reaching 1,200 readers. After two days, there were 890 who shared it reaching 4,800 people – and the story spread to Europe. After three days, the story had reached Australia, Iceland, Romania, Ireland, and the United Arab Emirates.

The maps below shows the 200 most recent visitors. Click any map for a larger gallery view.

What we do in life, for good or for bad, has an impact in the world. Live your life for good.

__________

* I didn’t name the ‘other’ local hospital because I really didn’t intend this article to be a criticism of that hospital, but instead a word of thanks to the team at Mercy and a general commentary about the importance of quality customer / patient care. I subsequently received comments from people who are very pleased with their own experiences at the ‘other’ hospital. I’ve also had some very positive experiences with various departments within the ‘other’ hospital. It’s just that their emergency room process and procedures could use some improving.

20 thoughts on “My Visit to the Emergency Room at Mercy Hospital in Iowa City

  1. The other hospital er has provided both services to my family. Great care when arriving via ambulance with my son. With my oldest very poor, from long waits when he was suicidal after major brain surgery to a resident telling us in front of him its a brain tumor like it was nothing. My oldest was 12. My other child was in the er two times and a critical result was not handed to us or even treated, just a passing note that the level was high and could be a contributing factor. I complained that it was overlooked and never treated to no response from the facility. I work for Mercy in Iowa City. I am bias on that aspect. But hands down the treatment when my son had his seizure and the prompt response to the odd spot one the MRI in my mind save my oldest son. The physician called the ped neuro unit at the other place. I think her actions saved his life, along with the trained neurosurgeon of the other hospital four months later when the tumor turned out to be cancer after all. Each has their plus, one is knowledgeable with many resources at their beck and call. The other has talent with a caring hand.

  2. I am glad you are feeling better, Greg. I am glad you received the medical attention that you needed. I also hope that you shared your unpleasant experience with the “other hospital’s” patient representatives, so appropriate attention can be given to change that behavior. It doesn’t take a rocket scientist to figure out which hospital it was, and I am so disappointed in the experience you had. I have proudly worked for that hospital since I graduated from high school, with the exception of a few years for nursing school and a move out of state for a couple years. If you have not shared your experience, I encourage you to do so. If you need help in who to contact, please let me know. I wish you all the best.

    1. Hi Cindy,

      Thanks for reading my story and for your thoughtful note. Stay tuned for my next story — a very positive experience at UIHC this week. 🙂

      Yes, if you could send me the name of who to contact regarding improvement suggestions that would be great. You can reach me through the Contact page http://AboutGregJohnson/Contact

      Greg

  3. You didn’t get a wait time approxomation at the other “local” hospital because there was probably a major trauma being attended to, or a child being airlifted in from across the state. You would have waited with the abdominal pain that turned out benign because you weren’t actually dying at the moment! A perfectly appropriate choice in your case would be mercy. If you ever have a real emergency, don’t expect that place to know up from down. If you need your life saved in a real emergency in an EMERGENCY dept, you go to the other local hospital***

    ***where it’s ok that your ignorance in one post won’t discriminate you from first class royal treatment when you need it most

    1. Thanks for taking time to read my story and comment. I’m sorry if what I wrote seemed to be coming from ignorance. I’ve subsequently had others provide similar advice as you have regarding serious trauma — that UIHC is the best and only regional hospital for such crisis situations. I wish the attendant that day could have explained that there was a ‘child being airlifted from across the state’ or whatever the case may have been. I didn’t see any ambulance there or anything serious going on, but perhaps the helicopter was on its way. In any event, I had a wonderful experience at UIHC this past week and plan to share that. ~ Greg

      1. I appreciated your thoughtful praise of Mercy’s service. However ER’s are there to aid you in your medical emergencies, not provide you with soft warm blankets or fluff your pillow for you. I’m glad that Mercy had the time to cater to you, but that was probably luck of the draw as far as timing. The “other” hospital you speak of very well could have been dealing with a major trauma or other very sick patient (or multiple sick patients), however it is against the law (HIPAA) to discuss such things with patients or even healthcare providers not involved in the case. It is completely unreasonable to expect to be told WHY the wait is going to be long.

        Things in the ER happen by *priority*, and abdominal pain is rarely a priority, especially if you don’t have a fever or any other abnormalities in your vital signs. Which I’m assuming you didn’t as it turned out to be a pulled muscle. I know it was probably the worst pain you’d ever had, but lots of people are in the ER with the worst pain they’ve ever had and its the nurses’ job to sort them by priority. The check in desk lady at the U can’t tell you who was ahead of you on the priority list or why, or what kind of mess was going on in back, but rest assured that the nurses and docs aren’t just sitting around drinking coffee when there are patients waiting.

        Unfortunately the triage nurse is never given the benefit of the doubt that he/she deserves and subsequently has to deal with the nasty stares and comments of people coming up to him/her all day asking how much longer. When truly, SHE DOESN’T KNOW.

      2. Dear Anonymous ER Nurse,

        Thanks for taking time to read my story and for your reply.

        I recognize, as most people do, that ER staff typically don’t have time to ‘fluff pillows’ as you put it. I don’t expect that from an ER visit, but it’s nice to receive at least some measure of kindness, care, and respect. Those are just basic guidelines of decency.

        One can provide a general estimate of how long it might take, without violating HIPAA laws. They don’t need to provide names of patients and conditions, “Well, let’s see, Bob Smith is ahead of you, and he’s back again because of his leg injury…” Obviously they don’t need to go into that kind of detail. Simply stating, “Well, there are ten people ahead of you with more serious conditions and it could be an hour” is sufficient. That doesn’t violate HIPAA regulations. I’ve asked for similar estimates at other doctor offices and medical clinics, including those at UIHC, and always received a polite response offering an estimated wait time. So, I guess I find it hard to believe that it’s a violation of HIPAA guidelines to offer a general estimate.

        I recognize, as does everyone, that an ER doesn’t function on a first come first served basis. We all recognize that it functions on a triage approach. At some point however, even the person with a stuffy nose deserves to be looked at if they’ve been there for 8 hours, continually being preempted by someone with a more serious condition. Although it turned out to be a pulled muscle, it could have been something more serious. I was actually referred to the ER by a UIHC doctor. So, I wasn’t just self-diagnosing. It was apparently serious enough that another doctor said I should have someone look at it immediately.

        The point of describing my experience at the ‘other’ hospital was not to write a critical review, but to provide a contrasting experience to demonstrate how the Mercy experience was exceptional. So, I’d not anticipated so many comments from people vehemently defending the ‘other’ hospital. If I’d wanted to write up a critical review, I would have written an article that focused specifically on that hospital’s ER.

  4. You didn’t have to mention it, I’ve been there! Mercy has treated me very well, and with such prompt professional and courteous care. I’m glad you are now ok.

  5. Although I’m happy you got the care in the manner you perceived best, I feel a need to respond as a 30 year veteran of one of the busiest ER’s in the state.
    It is with total despair that you actually, seriously refer to that which we use to laugh about: the “Burger King” ideal. The idea that the “next in line should be served first” would not stand up in court if we delay seeing the dying patient to attend to the patient with a twisted knee who happens to be next. I pray to God that we never get away from a world of prioritizing patients by their critical presentation, but we are slowly creeping toward making people “happy, cozy or feeling like they are in a resort.” Believe me, in utter honesty I could curl your hair with horror stories from the trenches, but what bothers me most is the idea that in an ER anyone could feel that that a comparison to fast food service is even close to realistic.
    Nowhere else on Earth will you find the environment you do in a large, metro ER which is expected to serve a vast populous quickly and efficiently. From sniffles and hang nails to pediatric CPR or code one car crash traumas, the general public literally has no concept of what happens behind those doors. That “other hospital” you were so dissatisfied with manages massive ground as well as air rescue traffic that arrives via a different entrance. Believe it or not, in the “big” hospitals we do get full to the point of no movement in the ER. Had your (hopefully) very knowledgeable triage nurse found a distressing variance in your vital signs or overall presentation, you would have been pushed back to be seen immediately. Unfortunately in times of high volumes, it would be possible that you would be placed on a cart in the hallway. That is never the safest or best practice for our patients. Overloading the staff resources with rooms AND hallways full creates a very unsafe environment. Our best practice is to move patients back as rooms become available.
    Oops! Now we address that waiting room patient demanding an actual time to be seen. How do we know? There is an incredible amount of variables affecting the opening of our rooms. Waits for private doctors, stitching up cuts, lab results, psych problems, even 1-3 hour deep cleanings for patients that have infectious diseases or bedbug infestations, not to mention horrid, unexpectedly crashing patients requiring a code or a trauma team called to the bedside. (I’m not even going to go into staffing issues here, but let’s say that a national nursing shortage also plays a huge part in delays) Too numerous to mention here, but all serious reasons which delay getting more patients in to be seen. I have spent innumerable hours in triage pissing people off by telling them that a room is being readied only to have that room assigned to a rescue coming in. Heart attacks and trauma ALWAYS win the room, therefore it becomes impossible to give a time.
    Patient flow in a 50-100 bed, frantically busy ER is difficult to anticipate, totally unlike estimating a time to get a burger wrapped or fries out of the basket. While smaller hospitals are often more likely in a position to “see those emergencies immediately” due to lower volumes, I can virtually guarantee you that had they been at patient capacity your experience may have been similar from one ER to the other.

    1. Hi Seymour,

      Thanks for reading my story and taking time to reply. I’m reminded of Paul Harvey who would say, “And now you know the rest of the story.”

      It helps to have this background.

      What may seem obvious to those of you working in the ER isn’t apparent to those of us who rarely visit. It’s too bad someone can’t print up what you wrote, and offer it on a three-fold brochure to those who arrive. Much of ‘customer satisfaction’ has to do with expectations.

      I do recognize that an ER can’t function like a fast food restaurant. I’ve been in ER situations before where you can sort of tell where you are in line based on everyone’s symptoms — regardless of when they arrived. The person with a stuffy nose waiting three hours will end up waiting longer than the person who just arrived with a life threatening condition. … and certainly fixing people up from life threatening trauma and injuries probably take a bit more time than it does to cook up another batch of fries.

      I think you really touched on the probably cause of delays when you said, “a national nursing shortage also plays a huge part in delays.”

      On one occasion I left a phone message with a certain department and it took three days for me to get a return phone call. Beyond being upset, I was simply perplexed, and took some time to visit with the nurse about the delay. She explained that in the past there were several staff people handing the hundreds of inbound phone calls and messages. Now she’s the only one for that department. Reducing staffing like a great way to save money, but probably doesn’t create the best results for employees or patients. Sometimes the quest for ‘efficiency’ and ‘savings’ ends up providing neither.

      I was surprised later to discover that report about national ER wait times. From that study, it seemed like most ER wait times are about the same, with some slightly longer. I guess it really depends on the circumstances when you arrive.

      Thanks for your through and thoughtful response.

      Greg

  6. Dear Greg, I wanted to thank you for the nice summary of the observations you made and the care you received at Mercy Hospital on July 16th, 2015. I was the nurse that took care of you and I cannot tell you how much my colleagues and I appreciated your compliments.
    I am glad you had a great experience and I hope that you and your family will continue to have these types of experiences.
    Thank you again.
    Sincerely,
    Joellen Megan RN BSN CEN

    1. Hi Joellen,

      I’m glad you had a chance to read my story! Thanks for taking time to reply. The care you and your colleagues provided really meant a lot. I just had to share my experience with others. Thanks again. 🙂

      Greg

  7. Thanks for your pleasant comments. I’m the clerk that checked you in and also a Senior clerk of 10 plus years. Having trained numerous others. I always stress in my training that no matter how many people are on the waiting room, you make everyone feel like they are the one that matters the most. I too have worked fast food and understand the analogy you presented. Thanks again for recognizing the work ethic I try to bring even on my worst days.

    1. Thanks, Alex. I’m really inspired to read your post. It’s a great example of how one person can impact so many in a positive way. Thanks for going above and beyond in your supervisory position to create an environment that fosters such quality care.

    1. It’s not about being ‘entitled.’ I’ve spent time in numerous undeveloped, ravished, and poverty stricken areas in the world where basics like water and electricity are scarce. I lived off-the-grid for 6 years. I’m appreciative and grateful daily for what we have.

      It’s not about entitlement. It’s a matter of wanting people and institutions to do what they can to make things better. When there’s an alternative that’s better, and it’s only 5-minutes away, that’s not being entitled, that’s just being smart.

      As it turns out, just about everything I’d complained about in my article was brought to the attention of the administrative staff at UIHC, and every single one of those issues has been corrected.

      Sometimes we just need to speak out and demand more. It’s not being ‘entitled’ but simply being human and asking for common decency and respect. Otherwise, the world around us devolves into chaos where nobody cares about anyone or anything.

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